The impact of aerosol box on tracheal intubation during the COVID‐19 pandemic: a systematic review

Introduction: This study aimed to summarize the effect of the aerosol box on tracheal intubation in patients with COVID-19. Areas covered: According to the PRISMA guidelines, a systematic search was performed to identify relevant literature on the ‘impact of the aerosol box on tracheal intubation during the COVID‐19 pandemic’ in different electronic databases up to March 2021. Based on a set of predefined inclusion and exclusion criteria, 447 articles were screened. Finally, 20 articles were included in the current systematic review. The findings showed that the use of aerosol box during intubation could reduce droplet contamination on the healthcare workers but not necessarily aerosols. An increase in the time of intubation with the aerosol box was also observed in 9 out of 12 studies (75%); however, three studies reported no significant difference in the time of intubation with and without the aerosol box. Most studies (8 out of 9, 89%) were also shown that intubation with the aerosol box may lead to more difficulty. Expert opinion: The proceduralist and other healthcare workers involved in airway management of COVID-19 infected patients should decide whether to apply the aerosol box with caution, balancing between benefits and risks, especially in difficult airway circumstances.